Project Summary/Abstract The overall goal of the Massachusetts Department of Public Health's Pregnancy Risk Assessment Monitoring System (PRAMS) is to collect data to improve the health of infants and mothers in the preconception, perinatal, or postpartum periods. Massachusetts (MA) has implemented PRAMS since 2007. PRAMS data were the first to quantify the oral health needs of pregnant and postpartum women in MA, and served as a catalyst to developing the MA Perinatal Oral Health Practice Guidelines for Pregnancy and Early Childhood. Concerning other areas of interest, reliable data are even more limited or nonexistent. For example, MA did not have population-based data on postpartum depression. PRAMS data supported the passage of ?An Act Relative to Postpartum Depression? bill in 2010 and since then new programs such as the Massachusetts Child Psychiatry Access Project (MCPAP) for Moms have begun to address maternal depression in MA. In addition, PRAMS data supported the selection of a mental health priority for the MA five-year Maternal and Child Health Title V Block Grant by including questions on social connectedness. MA is in a unique position to conduct linkages with its Pregnancy to Early Life Longitudinal (PELL) data system, a longitudinal database which includes a range of datasets linked together. Linkage of PRAMS and PELL data provides an innovative, longitudinal data system with a range of information on preconception and interconception health and health care utilization. It enables an assessment of the associations between maternal characteristics, experiences, attitudes and behaviors before, during and shortly after pregnancy with longer-term health outcomes (e.g. maternal and infant mortality, and subsequent maternal and infant hospital utilization and associated costs), which cannot be ascertained from a linkage of PRAMS data to birth certificate data alone. PRAMS methodology uses a mail survey with telephone follow up to inquire about maternal attitudes, experiences and behaviors. There are approximately 72,000 births annually, of which 2,400 are sampled for inclusion in MA PRAMS. The overall weighted response rate was 66.1%, 68.5%, and 67.5%, for 2010, 2011, and 2012, respectively.